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Evidence Informed Practice for Nursing

Evidence-Based Practice: Tutorial Video

5 Steps of Evidence-Informed Practice

  1. Construct a "searchable question" from a clinical scenario. (ASK)
  2. Plan and carry out a search of the literature for the best evidence. (ACQUIRE)
  3. Critically appraise the literature for validity and applicability. (APPRAISE)
  4. Apply the evidence to your clinical practice. (APPLY)
  5. Evaluate your performance. (ASSESS) 

Evidence-Based Practice Breakdown

Define your clinical question and break it down to identify key words. An answerable question involves a disorder or some other patient circumstance with a word such as who, what, where when, why and how (Thyer 2004). These key words can be used as search terms (Davis 2012).

In order to develop an effective clinical question it can be helpful to remember the acronym PICO: Population (P), Intervention/Influence (I), Comparison (C), and Outcome (O) (Polit and Cheryl (2014). 

Search for the right evidence, use PICO to streamline your search terms.

There are many information sources that can be used including: books, academic journal articles and personal experience.

In healthcare there are four primary sources of evidence: clinical and professional experience; patients and their carers; local context including professional networks and internal audits; and quality assurance feedback (Pooler, 2014).

An evidence hierarchy can be used to rank study findings according to the strength of the evidence they provide (Polit and Cheryl 2014). A pyramid is one of the most common. Systematic reviews are the pinnacle of all hierarchies (Polit and Cheryl 2014). 

Critically appraise the collected information to determine how useful it is at answering your question.

When appraising the evidence it is important to consider the following questions:

Are the results of the study valid?; What are the results and are they important?; Will the results help me care for my patients?; Does the research answer my question? (Melnyk, Fineout-Overholt, Stillwell and Williamson 2010).

Once you have evaluated the information you will now have to decide if it should be incorporated into your clinical practice (Pooler 2014).

In order to integrate this information effectively you will need to draw upon your own expertise and the patient’s values and circumstances (Thyer 2004).

It is important to consider both the benefits and risks of implementing any changes. 

Determine if the action you have taken has accomplished the desired result.

Remember to reflect upon your role and your interactions with patients, their carers and other healthcare team members (Pooler, 2014). 

Evidence-Based practice is primarily about using the best evidence and information for the care of individuals. This does not mean that evidence is used only to change practice but to guard against harmful change and support existing practice (Pooler 2014).

It should be a continuous process in order to ensure the best quality care for all patients but also for personal development as a healthcare professional (Pooler 2014).

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